I recently attended
the conference, 'Medical training, student experience and the transmission of
knowledge, c.1800-2014' (or #MTSE14 if you want to look over our
live tweets), at University College Dublin. Needless to say its focus, and the
discussion generated from its wide-ranging collection of papers, was excellent
and very much overdue.

Students dissecting

Medical education

Despite an ever-growing
interest in the history of medicine, the subject of medical education and
student experience continues to be overlooked (the last international symposium
dedicated to this subject having taken place in the early 1990s). Yet
throughout the nineteenth century medical education was being increasingly formalized,
centralized, and consolidated. It became the backbone of one’s medical career.
Strangely, however, it has occupied the negative space in histories of clinical
practice and patient care. This omission is incredibly problematic (but I
digress…).

So, whenLaura Kellyemailed to ask if I would give a paper at a conference devoted to the history
of medical training and knowledge production, I sent back an immediate and
unequivocal ‘YES!!’. (There were so many excellent papers about which I want to
talk that my own paper, ‘Venereology at the Polyclinic’, will have to take a
back seat for now.)

An important focus of MTSE
was the centrality of pedagogy. Traditionally, histories of medical education
have been written as administrative histories of major teaching hospitals. They
have concentrated on the big names, significant infrastructural changes, and
major medical developments that altered practice in these hospitals. Rarely
have such histories considered in the implications of the big names and
significant changes for the day-to-day learning and experiences of students. Happily, however,
historians of medicine are beginning to recognize the importance of
pedagogically-focused histories and MTSE really demonstrated this change. It
brought a whole host of issues to the fore and, as those of you who follow me
on Twitter will have gathered, I was rather excited by the rich collection of
papers.

John Harley Warner keynote address

We began with the keynote
address from John Harley Warner, who introduced us to his most resent and
gruesomely fascinating work on the photographic history of dissection in
American medical schools. As Warner observed, nineteenth-century medicine was
often a solitary occupation and so medical schools provided an important
opportunity for group learning and for developing a collective professional
identity. And this is particularly well-evidenced in the strange collections of
photographs in which groups of students posed around tables upon which they
were dissecting cadavers. One particularly interesting aspect of Warner’s
keynote was the figure of the medical school porter who often appeared in these
photographs and who Warner identified as playing a key role in the facilitation
of medical education (but I’ll return to this shortly).

Attendees at MTSE. Image courtesy of Real Smart Media.

Microbes to matron

Many fantastic papers
followed, including Claire Jones’s
presentation of her most recent research on the ‘Microbes to Matron’s’ project.
Her focus on the pedagogy and practice of infection control in British nursing
between 1870 and 1900 offers an important counterpoint to what have
traditionally been male-focused accounts of medical education. It is very easy
to forget that there were (and continue to be) other groups of trained medical
professionals beyond doctors who provided care to a wide cross-section of the
population. What also interested me about Jones’s paper were the types of
sources she and her fellow project investigators are drawing upon. By using
surgical nursing examinations, Jones demonstrated the increasingly active role
of nurses in their own education, and in surgical practice more broadly.

Dollhouse diorama

Crime scenes and dollhouse dioramas

Similarly, Neil Pemberton’s
paper on teaching crime scene investigation through dollhouse dioramas also
prompted us to reconsider the role of women in medical and scientific training.
By appropriating the traditional female practice of miniature making, women
like Frances Glessner Lee created a new way of thinking about crime scene
science. Nathalie Sage Pranchère
also looked at the important role of women in medicine, speaking about the
development of nineteenth-century French midwifery training. Importantly, she
also described how obstetric teachers used models to develop the anatomical and
obstetric knowledge of their midwifery students. As we saw with Pranchère’s
paper, the role of material objects in medical training and practice is
becoming an increasingly central focus of historical scholarship and this was
reflected throughout MTSE. For example, Jenna Dittmar used the collections from
Cambridge’s former Anatomical Museum to demonstrate how human remains allow
biological anthropologists to examine the historical tools and techniques of
dissection.

Spaces of medical education

Another important theme to
emerge from MTSE was the different spaces of medical education. Warner
described the dissection room as a space for developing collective professional
identify. Michael Brown spoke about the dynamic
space of the nineteenth century lecture theatre, in which students and their
lecturers were appealing to culturally resonant sets of values. Clare Hickman
presented eighteenth-century botanic gardens as important spaces for thinking
about the material culture of medical teaching. Hickman’s paper, like
Warner’s keynote, also demonstrated that the history of medical education is
never simply about those who learned the art of medicine but also those in the
background. Like the African American medical school porters who procured
cadavers for students, gardeners were important (but silent and overlooked
figures) in the maintenance of teaching spaces and the facilitation of teaching
practices.

Attendees at MTSE.Image courtesy of Real Smart Media.

MTSE demonstrated how the
nature of medical training has changed over time and within distinct national
contexts. Through an excellent collection of papers we explored the emergence
of centralized and consolidated systems of medical training. We looked at the
development of new tools of training and the different spaces in which these
tools were employed. And we looked at how medical knowledge and codes of
professional identity were being assimilated by medical and dental students,
nursing probationers, midwives, and qualified practitioners seeking further
education.

I came away from MTSE with
a new appreciation for the diversity of student experiences and systems of
knowledge dissemination, and will certainly be drawing upon these ideas in
future. With any luck, events like MTSE will slowly begin to generate greater
interest in the important place of medical training in wider narratives of
medical history.

Dr Anne Hanley is an LHRI Research Fellow at the University of Leeds with particular expertise in the history of modern medicine, medical education, health policy and the history of science. She recently completed her PhD at the University of Cambridge on the development and dissemination of venereological knowledge among English medical professionals, 1886-1913. She writes a blog Clinical Curiosities and tweets at @annerhanley.